Lithium as a Pharmaceutical
In 1949, John Cade demonstrated the efficacy of lithium in modifying the mood of patients suffering from certain psychiatric disorders. Administrating lithium-carbonate (Li2CO3) to patients with mania had a dramatic effect in tempering their mania and stabilizing their mood, although depressed patients were less responsive. Cade's discovery, reported in the paper “Lithium Salts in the Treatment of Psychotic Excitement,” prompted further research, and in 1970 lithium-carbonate was approved by the U.S. FDA for the treatment of mania and bipolar disorder. Lithium citrate (Li3C6H5O7) is also FDA approved for mania (and bipolar disorder). The discovery of lithium's role as a mood suppressant and stabilizer was later hailed by the award winning author Kay Redfield Jamison as “one of the most important advances in modern psychiatry.”
Like any psychiatric pharmaceutical, however, lithium is only effective in treating a restricted class of mental disorders. While lithium is, to this day, perhaps the best treatment for mania and other mental disorders with a strong manic component, like bipolar disorder, it is largely ineffective and seldom used in treating psychotic disorders such as schizophrenia and schizo-effective disorders or in treating (unipolar) major depression. Moreover, there are patients suffering from mania who are not treated effectively with lithium. Anti-psychotic medications, especially clozapine, can reduce the suffering of some schizophrenic patients, and there are several classes of anti-depressants (for example the tri-cyclic antidepressants, Wellbutrin and serotonin-re-uptake inhibitors, the SSRI's, such as Prozac) which have been effective in treating patients with depression and other mental disorders with reduced or impaired cognitive functioning. However, there are patients with mental illness whose conditions are drug-resistant. Electro-shock therapy has been effective at treating some drug-resistant patients with major depression, and magnetic stimulation techniques such as transcranial magneto-stimulation (TMS) does appear to benefit some depressed patients.
All psychiatric pharmaceuticals can, and usually do, have unwanted side effects, which range across a broad spectrum (such as suppression of sexual libido especially problematic for the SSRI's, increased heart-beat rates and reduced blood pressure quite serious for the tri-cyclic anti-depressants). Patients on some psychiatric medications require regular blood monitoring to prevent toxicity, such as monitoring white blood cell counts for patients taking clozapine to reduce the risk of agranulocytosis which can be fatal, and monitoring lithium blood levels to diminish the risk of kidney damage for those patients taking lithium. Electro-shock therapy can cause short-term and occasionally long term memory loss. The short-term side effects of transcranial magneto-stimulation are mild although the rare occurrence of induced seizures is an acute risk. In view of the incredible human toll that mental disorders inflict, not to mention the economic impact, there is a pressing need for new psychiatric pharmaceuticals and treatments.